The efficacy of peri-operative interventions to decrease postoperative delirium in non-cardiac surgery: a systematic...

Area of Science:

• Gerontology
• Anesthesiology
• Surgical Patient Care

Background:

• Postoperative delirium is a common complication in non-cardiac surgery.
• Identifying effective peri-operative interventions is crucial for improving patient outcomes.

Purpose of the Study:

• To determine the efficacy of various peri-operative interventions in reducing the incidence of postoperative delirium.

Main Methods:

• A systematic review and meta-analysis of randomized controlled trials was conducted.
• Searched four databases adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
• Included 29 trials focusing on non-cardiac surgery with peri-operative interventions and delirium outcomes.

Main Results:

• Peri-operative geriatric consultation significantly decreased postoperative delirium (OR 0.46, 95% CI 0.32-0.67).
• Lighter anesthesia was associated with a decreased incidence of delirium (OR 2.66, 95% CI 1.27-5.56).
• Other interventions like prophylactic haloperidol, bright light therapy, and general anesthesia showed potential protective effects.

Conclusions:

• Peri-operative geriatric consultations, particularly with multicomponent interventions, are effective in reducing postoperative delirium.
• Lighter anesthesia techniques represent a promising strategy for delirium prevention.
• Further research may explore the combined effects of these interventions.